Prevalence of sinonasal outcome test (SNOT‐22) symptoms in patients undergoing surgery for chronic rhinosinusitis in the England and Wales National prospective audit

Abdalla, Salma M; Al-Reefy, Hiba; Hopkins, Claire

doi:10.1111/j.1749-4486.2012.02527.x

Cited by 85 publications

(92 citation statements)

References 15 publications

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“…All patients complained of nasal obstruction and the need to blow their nose. Nasal congestion is the most prevalent and severe individual symptom in preoperative CRS patients as reported by Abdalla et al . The baseline nasal congestion score was 3.8 ± 0.5 on a 0 to 5 scale, in line with what was reported for preoperative CRS patients in Abdalla's study .…”

Section: Resultssupporting

confidence: 85%

Phase 1 clinical study to assess the safety of a novel drug delivery system providing long‐term topical steroid therapy for chronic rhinosinusitis

Douglas

Psaltis

Rimmer

et al. 2019

Int Forum Allergy Rhinol

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Background Chronic rhinosinusitis (CRS) patients who fail medical management have few treatment options other than endoscopic sinus surgery (ESS). A novel biodegradable mometasone furoate drug delivery system (LYR‐210) providing continuous topical steroid therapy to sinonasal mucosa over 24 weeks was developed to treat unoperated CRS patients who have failed medical management prior to ESS. LYR‐210 was designed to slowly expand in the middle meatus, ensuring efficient drug delivery as mucosal swelling reduces. Methods A prospective, multicenter, open‐label study was conducted in 20 CRS subjects who were determined to be candidates for ESS. Under endoscopic guidance and topical anesthesia, LYR‐210 was placed in both middle meatuses. The primary endpoint was product‐related serious adverse events (SAEs) at 4 weeks. Additional assessments included plasma drug concentration, morning serum cortisol levels, intraocular pressures (IOPs), and Sino‐Nasal Outcome Test (SNOT‐22) scores. Results LYR‐210 was successfully placed bilaterally in 20 subjects (12 without nasal polyps and 8 with polyps) in an office setting. There were no product‐related SAEs through 24 weeks, at which point 86% of LYR‐210 depots were still retained in the middle meatus. Serum cortisol, IOP, and plasma drug concentrations supported systemic safety at all time points tested. Subjects experienced significant reductions in their SNOT‐22 scores as early as week 1, and this reduction persisted through week 24 (p < 0.01). Significant symptom improvement was achieved in the SNOT‐22 rhinologic, extranasal rhinologic, ear‐facial, psychological, and sleep dysfunction subdomains at 24 weeks (p < 0.05). Conclusion LYR‐210 is safe and well‐tolerated in ESS‐naive CRS patients and leads to sustained symptom improvement in patients.

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Section: Resultssupporting

confidence: 85%

Phase 1 clinical study to assess the safety of a novel drug delivery system providing long‐term topical steroid therapy for chronic rhinosinusitis

Douglas

Psaltis

Rimmer

et al. 2019

Int Forum Allergy Rhinol

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“…The results of the study with postoperative reduction in SNOT-22 score of more than 50 % in both the CRSwNP and CRSsNP groups, are in line with a high international standard [4,25,27], and confirms the efficacy of ESS on quality of life improvement for patients with severe CRS.…”

Section: Strengths and Weaknesssupporting

confidence: 82%

Efficacy of ESS in chronic rhinosinusitis with and without nasal polyposis: a Danish cohort study

Lind

Joergensen

Lange

et al. 2015

Eur Arch Otorhinolaryngol

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Endoscopic sinus surgery (ESS) for patients with severe chronic rhinosinusitis (CRS) has become a well-established treatment in cases where medical therapy fails. Even though CRS patients are divided into two subgroups, CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP), most studies present only results for the total cohort. This prospective cohort study evaluated the efficacy of ESS on both quality of life and olfactory function measures, in a cohort of Danish CRS patients diagnosed according to the EPOS criteria, with results analysed separately for the CRSwNP and CRSsNP subgroups. All 97 CRS patients who underwent ESS over an 18-month trial period were evaluated preoperative by SNOT-22 score, Sniffin' Sticks score, modified Lund-Kennedy endoscopic score and Lund-Mackay CT score. Patient outcomes were reevaluated at clinical follow-up 1 and 6 months postoperative. ESS efficiently and immediately improved quality of life for both CRSwNP and CRSsNP patients, with over 50 % reduction in SNOT-22 score 1 month after surgery, which sustained 6 months postoperative. Olfactory function measured by Sniffin' Sticks score showed overall improvement in both groups. ESS efficiently improved quality of life in both CRSwNP and CRSsNP patients, and surgery lead to an overall improvement in olfactory function. However, a minor proportion of patients experienced deterioration in olfactory function after ESS.

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“…The questionnaire we used to screen for sinonasal disease was developed in adults, but other measures of sinonasal disease gave scores similar to those previously reported for children with chronic rhinosinutis and perennial rhinitis, suggesting the study group had significant disease that could respond to intervention. 29,38-42 This lack of improvement was unexpected given that previous studies show nasal mometasone in the dose used in this study is effective for the treatment of rhinitis in children, 43 and nasal corticosteroids are considered first line therapy for the treatment of sinonasal disease in children. 44 Although we do not know the reason for the lack of improvement, it is possible that adherence or drug delivery was more challenging in children than adults.…”

Section: Discussionmentioning

confidence: 80%

Efficacy of nasal mometasone for the treatment of chronic sinonasal disease in patients with inadequately controlled asthma

Dixon

Castro

Cohen³

et al. 2015

Journal of Allergy and Clinical Immunology

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Background Chronic sinonasal disease is common in asthma and associated with poor asthma control; however there are no long term trials addressing whether chronic treatment of sinonasal disease improves asthma control. Objective To determine if treatment of chronic sinonasal disease with nasal corticosteroids improves asthma control as measured by the Childhood Asthma Control Test (cACT) and Asthma Control Test (ACT) in children and adults respectively. Methods A 24 week multi-center randomized placebo controlled double-blinded trial of placebo versus nasal mometasone in adults and children with inadequately controlled asthma. Treatments were randomly assigned with concealment of allocation. Results 237 adults and 151 children were randomized to nasal mometasone versus placebo, 319 participants completed the study. There was no difference in the cACT (difference in change with mometasone – change with placebo [ΔM - ΔP]: -0.38, CI: -2.19 to 1.44, p = 0.68 ages 6 to 11) or the ACT (ΔM - ΔP: 0.51, CI: -0.46 to 1.48, p = 0.30, ages 12 and older) in those assigned to mometasone versus placebo. In children and adolescents, ages 6 to 17, there was no difference in asthma or sinus symptoms, but a decrease in episodes of poorly controlled asthma defined by a drop in peak flow. In adults there was a small difference in asthma symptoms measured by the Asthma Symptom Utility Index (ΔM - ΔP: 0.06, CI: 0.01 to 0.11, p <0.01) and in nasal symptoms (sinus symptom score ΔM - ΔP: -3.82, CI: -7.19 to- 0.45, p =0.03), but no difference in asthma quality of life, lung function or episodes of poorly controlled asthma in adults assigned to mometasone versus placebo. Conclusions Treatment of chronic sinonasal disease with nasal corticosteroids for 24 weeks does not improve asthma control. Treatment of sinonasal disease in asthma should be determined by the need to treat sinonasal disease rather than to improve asthma control.

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Prevalence of sinonasal outcome test (SNOT‐22) symptoms in patients undergoing surgery for chronic rhinosinusitis in the England and Wales National prospective audit

Abstract: The leading three symptoms were nasal blockage/congestion, altered taste/smell and the need to blow the nose in terms of severity and prevalence. The total Sino-Nasal Outcome Test 22 and all individual symptom scores improved significantly after surgery.

Cited by 85 publications

References 15 publications

Phase 1 clinical study to assess the safety of a novel drug delivery system providing long‐term topical steroid therapy for chronic rhinosinusitis

Phase 1 clinical study to assess the safety of a novel drug delivery system providing long‐term topical steroid therapy for chronic rhinosinusitis

Efficacy of ESS in chronic rhinosinusitis with and without nasal polyposis: a Danish cohort study

Efficacy of nasal mometasone for the treatment of chronic sinonasal disease in patients with inadequately controlled asthma

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